J-7 _MSC-Ship-Rpr-Facility-Surv.pdf

ATTACHMENT J - 7 MSC Form 4330/26

NOTE: If survey form has been previously submitted, then enter changes only.

MSC SHIP REPAIR FACILITY SURVEY

DATE:

SHIPYARD AND ADDRESS SHIPYARD DATA

Commander (Code M-4E3)

Military Sealift Command

Washington, DC 20390

Telephone No:

Telex No:

Date Found:

NO. LAUNCHING DIMENSIONS MAXIMUM SHIP SIZE

OF (check one) (ton 2,240 lbs)

BUILDING WAYS (M. I. W.)

DEPTH OF WATER

CRANES SERVING WAY

WAY OVER AT DROP LIFT CAPACITY CERTIFICATION DATE &

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WAY END OFF NO. TYPE (std. tons) CERTIFIED BY WHOM

DEPTH: DEPTH:

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DEPTH: DEPTH:

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DEPTH: DEPTH:

LENGTH OF LAUNCHING RUN DEPTH OF RUN AT M.L.W.

TIDAL RANGE (DIFF. OF M.L. M.H) IS FIRE PROTECTION AVAILABLE

ON BUILDING WAY?

YES NO

IS SNUBBING NECESSARY?

YES NO

N32205-16-C-4006 USNS JOHN LENTHALL (TAO-189)

SHEET 1 OF 5

MSC SHIP REPAIR FACILITY SURVEY (continued) SHIPYARD:

BERTHS OF SHIPS (Piers, Wharves, Bulkheads, etc.) DRY DOCKS (means high water)

NO. TYPE LENGTH

WATER DEPTH

(M. L. W.)

HEIGHT

OF

USE

REPAIR/

SERVICES AVAILABLE

DOCK

MATERIAL TYPE

(actual & usable)

ACT:

USE:

ACT:

USE:

ACT:

USE:

ACT:

USE:

ACT:

USE:

ACT:

USE:

IN-

BOARD

OUT-

BOARD

DOCK

(M.L.W.)

OUTFIT-

ING

(use abbreviation of service below) NO. Floating--(FD)

Graving--(GD) Marine Railway (MR)

MAXIMUM SHIP SIZE

LENGTH

CLEAR WIDTH

DRY DOCKS (continued)

DEPTH/DRAFT

DATE CERTIFIED, CERTIFIED BY WHOM, &

DOCK

NO.

ACCOMMODATED

LENGTH OA-BEAM

at coping (GD), at keel blocks

OVERALL on cradle (MR), on PONTOON

(FD)

at top cradle (MR), at keel at top inboard block wing wall (FD, GD) height

OVER OVER OVER

SILL FLOOR KEEL

(GD) BLOCKS

LIFTING CAPACITY

(ton 2,240)

DATE CERTIFICATION EXPIRES

LEGEND (abbreviation of services)

Fresh Water --- F.W. - G.P.M. - P.S.I. Steam --- S - P/HR - P.S.I. Electric Power --- E - V - AC - AMP Fire Protection --- FP - G.P.M. - P.S.I.

Salt Water ----- S.W. - G.P.M. - P.S.I Air ------ A - C.F.M. - P.S.I. Electric Power --- E - V- DC - AMP Sanitary Sewer --SS - YES - NO

MSC SHIP REPAIR FACILITY SURVEY (continued) SHIPYARD:

BERTHING, SHOP OR YARD CRANES; STATIONARY, RAIL, MOBILE, OR BRIDGE (3 tons or over)

MAX REACH HEIGHT OF HOOK

NO TYPE CAPACITY MAX SPAN CAPACITY BOOM HEIGHT ABOVE BASE HEIGHT OF HOOK AREA SERVICE DATE CERTIFIED, CERTIFIED BY WHOM

& (STD TONS) (BRIDGE) AT REACH LENGTH HINGE ABOUT REACH (BRIDGE) DATE CERTIFICATION EXPIRES

NAVIGATIONAL RESTRICTIONS (indicate at M.L.W.)

MINIMUM CHANNEL (depth width) MINIMUM HORIZONTAL AND VERTICAL BRIDGE CLEARANCES

DISTANCE TO NEAREST DISTANCE TO NEAREST AIRPORT

RAILROAD CONNECTION (identify)

LIST ANY OTHER RESTRICTIONS (include projects under construction which will after navigational restrictions)

MSC SHIP FACILITY SURVEY (continued)

PRINCIPAL SHOPS AND BUILDINGS

LARGEST EXIT

SHIPYARD:

STORAGE SPACE FOR COMPONENTS AND MATERIALS

(LIST DIMENSIONS FOR EACH AREA, PLUS TYPE MATERIAL STORED)

NAME OF SHOP

OR BUILDING

FABRICATING

PLATE

SHEET METAL

SUBASSEMBLY

WOOD WORKING

BOAT ASSEMBLY

OR MOLDING

BOILER

MACHINE

ELECTRICAL

ELECTRONIC

PIPE

FOUNDRY

RIGGER

DIMENSIONS OF

SHOP OR BUILDING

WIDTH HEIGHT

ALL OTHER SHOPS

(LIST NAMES AND DIMENSIONS)

RAW STEEL STORAGE (SQ. FT.) ___________________________________________________________

WELDING AND ASSEMBLY (SQ. FT.) _______________________________________________________

LIST TYPES OF WORK NORMALLY SUBCONTRACTED ACREAGE LEGALLY CONTROLLED

IN USE DEVELOPED TOTAL

MSC SHIP REPAIR FACILITY SURVEY (continued)

LIST ANY EQUIPMENT OR CAPABILITY NOT OTHERWISE DESCRIBED IN THIS FORM

SHIPYARD:

EMPLOYMENT

MANAGEMENT, ADMINISTRATION

PROFESSIONAL ENGINEERING

PRODUCTION SKILLED

PRODUCTION UNSKILLED

NONPRODUCTION

TOTAL:

CURRENT

CURRENT

SHIFTS POTENTIAL MAXIMUM

MAXIMUM

SHIFTS NORMAL

NORMAL

SHIFTS

REQUIRED SUBMITTALS TO ACCOMPANY THIS FORM:

1. PLOT PLAN OF YARD.

2. CERTIFIED DEPTH OF WATER PLOT

3. FOR EACH SHOP LISTED ON SHEET 4, A LIST OF MACHINE TOOLS AND

EQUIPMENT WHICH INDICATES THE CAPACITIES OF THE SHOP.

4. A GENERAL STATEMENT (INCLUE, NAME OF SHIP, DATES, AND

DOLLAR AMONT OF JOB) OF SHIP REPAPIR WORK WHICH HAS BEEN

ACCOMPLISHED BY THE APPLICANT.

5. LISTING OF OFFICIALS AND THE QUALIFICATIONS OF EACH FOR SHIP

REPAIR (INCLUDE AS A MINIMUM JOBS HELD, YEARS, HELD, ONE LINE

6. IF FACILITIES ARE LOCATED AT MORE THAN ONE LOCATION THEN

LIST EACH FACILITY AND ITS LOCATION.

7. POINT OF CONTACT FOR INFORMATION SUBMITTED IN THIS FORM

(NAME/TITLE/PHONE NUMBER).

ARE YOU CERTIFIED AS A SMALL BUSINESS ? YES NO

NAME AND TITLE OF SENIOR SURVEYOR SIGNATURE DATE SIGNED